Gaps in Hepatitis B Vaccination Completion and Sero-Protection for People Who Inject Drugs in Hpakant, Myanmar, 2015–2018

Yee, N Shwe; Naing, Aung Yu; Cuesta, Julita Gil; Das, Mrinalini; Dave, Kapilkumar

doi:10.3390/tropicalmed5020077

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…There is also a sizeable mobile population and historically frequent outbreaks of conflict likely to produce particular health needs among the population, but which have not yet been researched [ 12 ]. Harm reduction services at Waingmaw service centre include psychosocial counselling, social support, health education, distribution of needles and syringes, condoms, facilitating access to methadone maintenance therapy (MMT), provision of HIV, TB and viral hepatitis prevention, diagnostics and treatment, overdose management, and other medical services through drop-in centres, key population service centres, mobile medical teams, outreach and community-based activities [ 39 ].…”

Section: Methodsmentioning

confidence: 99%

The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar

et al. 2023

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Background Evidence on the social determinants of mental health conditions and violence among people who inject or use drugs (PWUD) is limited, particularly in conflict-affected countries. We estimated the prevalence of symptoms of anxiety or depression and experience of emotional or physical violence among PWUD in Kachin State in Myanmar and examined their association with structural determinants, focusing on types of past migration (migration for any reason, economic or forced displacement). Materials A cross-sectional survey was conducted among PWUD attending a harm reduction centre between July and November 2021 in Kachin State, Myanmar. We used logistic regression models to measure associations between past migration, economic migration and forced displacement on two outcomes (1) symptoms of anxiety or depression (Patient Health Questionnaire-4) and (2) physical or emotional violence (last 12 months), adjusted for key confounders. Results A total of 406, predominantly male (96.8%), PWUD were recruited. The median age (IQR) was 30 (25, 37) years, most injected drugs (81.5%) and more commonly opioid substances such as heroin or opium (85%). Symptoms of anxiety or depression (PHQ4 ≥ 6) were high (32.8%) as was physical or emotional violence in the last 12 months (61.8%). Almost one-third (28.3%) had not lived in Waingmaw for their whole life (migration for any reason), 77.9% had left home for work at some point (economic migration) and 19.5% had been forced to leave home due to war or armed conflict (forced displacement). A third were in unstable housing in the last 3 months (30.1%) and reported going hungry in the last 12 months (27.7%). Only forced displacement was associated with symptoms of anxiety or depression [adjusted odds ratio, aOR 2.33 (95% confidence interval, CI 1.32–4.11)] and recent experience of violence [aOR 2.18 (95% CI 1.15–4.15)]. Conclusion Findings highlight the importance of mental health services integrated into existing harm reduction services to address high levels of anxiety or depression among PWUD, particularly among those who have been displaced through armed conflict or war. Findings reinforce the need to address broader social determinants, in the form of food poverty, unstable housing and stigma, in order to reduce mental health and violence.

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Section: Methodsmentioning

confidence: 99%

The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar

et al. 2023

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“…Universal childhood vaccination campaigns initiated in the 1990s have been effective in reducing mother-to-child transmission [ 3 ]. However, these campaigns require 90% coverage to reduce infections to < 1% [ 4 ], a goal that is hard to reach in many low-resource settings, especially in rural [ 5 ] and marginalized migrant populations [ 6 , 7 ]. The COVID-19 pandemic has disrupted routine health services globally, resulting in decreased vaccination rates affecting millions of children [ 8 ], but differential effects on marginalized populations have not been explored.…”

Section: Introductionmentioning

confidence: 99%

Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

Gilder

Pateekhum

Hashmi

et al. 2022

Int J Equity Health

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Background Hepatitis B causes significant disease and death globally, despite the availability of effective vaccination. Migration likewise affects hundreds of millions of people annually, many of whom are women and children, and increases risks for poor vaccine completion and mother to child transmission of hepatitis B. In the neighbouring countries of Thailand and Myanmar, vaccine campaigns have made progress but little is known about the reach of these programs into migrant worker communities from Myanmar living in Thailand. Methods A cohort of 253 postpartum women (53 urban migrants in Chiang Mai and 200 rural migrants in Tak Province) were surveyed about their Hepatitis B knowledge and willingness to vaccinate their children between September 10, 2019 and March 30, 2019. They were subsequently followed to determine vaccine completion. When records of vaccination were unavailable at the birth facility, or visits were late, families were contacted and interviewed about vaccination elsewhere, and reasons for late or missed vaccines. Results Though women in Tak province displayed better knowledge of Hepatitis B and equal intention to vaccinate, they were 14 times less likely to complete Hepatitis B vaccination for their children compared to migrants in Chiang Mai. Tak women were largely undocumented, had private (non-profit) insurance and had more transient residence. In Chiang Mai migrant women were mostly documented and had full access to the Thai national health services. Though minor individual and facility-level differences may have contributed, the major driver of the disparity seems to be the place of migrants within local socio-political-economic systems. The COVID-19 pandemic further disproportionately affected Tak province migrants who faced severe travel restrictions hampering vaccination. Sixty percent of families who were lost to vaccine follow-up in Tak province could not be contacted by phone or home visit. Chiang Mai migrants, with 86.8% vaccine completion, nearly reached the target of 90%. Conclusions Achievement of high levels of hepatitis B vaccination in migrant communities is important and feasible, and requires inclusive policies that integrate migrants into national health and social services. This is more urgent than ever during the COVID-19 era.

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Gaps in Hepatitis B Vaccination Completion and Sero-Protection for People Who Inject Drugs in Hpakant, Myanmar, 2015–2018

Cited by 2 publications

References 9 publications

The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar

The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar

Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic

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